DENVER -- Some are calling it the next big frontier in cardiac treatment -- injecting stem cells to regenerate the heart. But the experimental procedure means major surgery.

Now doctors are opening the door for heart patients who want to test the benefits of stem cells -- without an operation.

Max Eaton had already had one heart attack behind him, but is now struggling with heart failure. He's hoping stem cells are the answer to heal his ailing heart.

"I happened to run into this article, which was the second or third time I heard about this stem cell research and decided nothing ventured, nothing gained," Eaton said.

Instead of surgery where the chest is opened and stem cells are injected into the heart, Dr. Alan Heldman delivers the cells through a catheter that's threaded through the groin.

The spiral-shaped needle at the tip is screwed into the heart.

"We can now inject the cells exactly where we want to in the inside part of the heart, and we can do it in multiple different locations," said Dr. Joshua Hare.

Doctors say it's a more efficient way of delivering stem cells.

"By using this needle that has a corkscrew-shaped tip, we have some evidence that the fraction of cells that actually stay in the heart as opposed to leaking out through the injection tract is much higher," said Heldman.

Hare said using a catheter could allow millions more people to be treated who aren't strong enough for surgery.

"This could become an outpatient procedure or maybe a one night in the hospital type of procedure," Hare said.

Eaton was eager to be first in line despite risks like damage to the heart and blood vessels.

"The small risk of doing something and perhaps maintaining a reasonable lifestyle a little seemed well worth it," Eaton said.

Doctors say Eaton is responding well to his stem cell treatment. All of the stem cells being used in this trial are adult stem cells.

Studies have shown injecting heart attack patients with adult stem cells increased the pumping power of the heart. However, it is not an approved treatment for re-growing heart tissue.

BACKGROUND: The American Heart Association estimates 80 million American adults -- or one in three -- have at least one form of heart disease. Nearly 6 million of these adults suffer from heart failure, an irreversible condition that often requires a heart transplant. Heart failure can be caused by many factors, including long-term heart disease and multiple heart attacks.

RE-GROWING DAMAGED TISSUE: Because blood supply is cut off from muscle cells in the heart during an attack, that tissue can suffer permanent injury or death.

"The fundamental problem with heart attacks and heart failure is that the heart loses functioning muscle cells, and when you lose those functioning muscle cells, the heart goes into failure," said Dr. Joshua Hare, a cardiologist at the University of Miami. "Up until now we’ve had no therapy that can replace those missing cells."

Now, doctors are turning to stem cells to re-grow heart tissue.

"The overall goal of stem cell therapy for the heart is to replace those missing cells and rebuild the heart or restore the heart back to what it was originally," Hare said.

To treat the heart, doctors inject stem cells either into the bloodstream, the coronary artery or directly into the organ. Until now, most research involving this treatment has been in patients who have just suffered a heart attack, before scar tissue has formed.

A MORE EFFICIENT WAY: Doctors at the University of Miami are testing a new method of stem cell delivery that they hope is beneficial for patients with heart failure.

"We're really at the beginning of a new field of inquiry, asking the question, 'Can we treat patients whose heart attack may have been three months ago, three years ago or even longer?'" said Dr. Allan Helman, an interventional cardiologist at the University of Miami. The new technique involves a novel, corkscrew-shaped catheter through which surgeons inject bone marrow stem cells directly into the heart.

"The advantage of a screw-in needle is that there is better retention of what's been injected into the muscle," Heldman said.

As with other types of catheters, patients don't have to undergo surgery to receive the treatment. While the patient is lightly sedated, a catheter is threaded through a blood vessel into the aorta, and ultimately into heart muscle. Doctors navigate the heart during surgery using magnetic resonance imagining (MRI).

FOR MORE INFORMATION, CONTACT

Omar Montejo
Miller School of Medicine
University of Miami
(305) 243-5654